Health in Israel - Health Insurance Law

Health Insurance Law

In 1995 the National Health Insurance Law came into effect, which made membership in one of the four existing Health Maintenance Organizations compulsory for all Israeli citizens. The law determined a uniform benefits package (סל בריאות) for all citizens - a list of medical services and treatments which each of the Health Maintenance Organizations is required to fund for its members. Additionally, certain services were brought under the direct administration of the State, usually by means of the Health Ministry. In addition, the law set out a system of public funding for health care services by means of a progressive health tax, administered by Bituah Leumi, Israel's social security organization, which transfers funding to the Health Maintenance Organizations according to a certain formula based on the number of members in each fund, the age distribution of members, and a number of other indices. The Health Maintenance Organizations also receive direct financing from the states money.

Before enactment the Health Insurance Law, the only Health Maintenance Organization to accept members without discrimination based on age or medical situation was the Clalit HMO which was then in the ownership of the Histadrut labour federation. After enactment of the 1995 law, membership in any of the four Health Maintenance Organizations was guaranteed for all citizens, and Israelis were given the right to transfer between Organizations once per year.

The 1995 law also imposed a system of financial and medical oversight of HMOs by the State. In addition to the uniform benefits package provided to all citizens, which provides coverage for basic and essential health care, every HMO fund provides their members with the option to acquire "supplementary insurance" (ביטוח משלים), which includes services and treatments that are not covered by the publicly funded system.

The four nationwide HMOs are: Clalit (the largest with about 54% of the population belonging to it), Maccabi, Kupat Holim Meuhedet and Leumit.

Israel has maintained a system of socialized health care since its establishment in 1948, although the National Health Insurance law was passed only on January 1, 1995. The state is responsible for providing health services to all residents of the country, who can register with one of the four health service funds. To be eligible, a citizen must pay a health insurance tax. Coverage includes medical diagnosis and treatment, preventive medicine, hospitalization (general, maternity, psychiatric and chronic), surgery and transplants, preventive dental care for children, first aid and transportation to a hospital or clinic, medical services at the workplace, treatment for drug abuse and alcoholism, medical equipment and appliances, obstetrics and fertility treatment, medication, treatment of chronic diseases and paramedical services such as physiotherapy and occupational therapy.